Geographic and Socio-demographic Determinants of Plasma Retinol Concentrations in Chinese Pregnant and Lactating Women

Overview

Journal Eur J Nutr

Specialty Nutritional Sciences

Date 2021 Dec 3

PMID 34860270

Authors

Yubo Zhou

Keyi Si

Hongtian Li

Xiucui Li

Sherry A Tanumihardjo

Jianmeng Liu

Affiliations

Soon will be listed here.

Abstract

Purpose: To examine plasma retinol status and its determinants in Chinese pregnant or lactating women.

Methods: A cross-sectional study involving 1211 healthy women in mid-pregnancy, late pregnancy, or lactation was conducted in northern, central, and southern China. Plasma retinol concentration was determined by high-performance liquid chromatography. Multivariate quantile regression or modified Poisson regression was used to estimate adjusted medians, or to examine the associations of suboptimal retinol concentration (< 1.05 µmol/L) with various factors.

Results: The overall median (interquartile range) retinol concentration was 1.25 (1.06-1.46) µmol/L. The adjusted concentration was higher in women at lactation (1.39 [1.20-1.63] µmol/L) and mid-pregnancy (1.26 [1.10-1.44] µmol/L) than late pregnancy (1.07 [0.92-1.28] µmol/L), and higher in women in the central area (1.34 [1.18-1.49] µmol/L) and the north (1.26 [1.10-1.43] µmol/L) than the south (1.19 [1.07-1.31] µmol/L). The retinol concentration was more likely to be low in women with lower pre-pregnancy BMI, younger age, less education, and in lactating women who had a caesarean birth or were breastfeeding exclusively. A total of 290 (24.0%) women had a suboptimal retinol concentration, and the prevalence was higher in women at late pregnancy, residing in the south, with younger age, and having underweight pre-pregnancy.

Conclusion: About one-fourth of pregnant or lactating women in China had suboptimal retinol concentrations that varied with phases of pregnancy and lactation, region of residence, and socio-demographic characteristics, indicating a need for population-specific public health strategies to optimize vitamin A status.

References

Hansen L, Sigman C, Andreola F, Ross S, Kelloff G, De Luca L . Retinoids in chemoprevention and differentiation therapy. Carcinogenesis. 2000; 21(7):1271-9. View

Neves P, Castro M, Oliveira C, Malta M, Lourenco B, Cardoso M . Effect of Vitamin A status during pregnancy on maternal anemia and newborn birth weight: results from a cohort study in the Western Brazilian Amazon. Eur J Nutr. 2018; 59(1):45-56. DOI: 10.1007/s00394-018-1880-1. View

Radhika M, Bhaskaram P, Balakrishna N, Ramalakshmi B, Devi S, Kumar B . Effects of vitamin A deficiency during pregnancy on maternal and child health. BJOG. 2002; 109(6):689-93. DOI: 10.1111/j.1471-0528.2002.01010.x. View

Bao Y, Ibram G, Blaner W, Quesenberry C, Shen L, McKeague I . Low maternal retinol as a risk factor for schizophrenia in adult offspring. Schizophr Res. 2012; 137(1-3):159-65. PMC: 3520602. DOI: 10.1016/j.schres.2012.02.004. View

Checkley W, West Jr K, Wise R, Baldwin M, Wu L, LeClerq S . Maternal vitamin A supplementation and lung function in offspring. N Engl J Med. 2010; 362(19):1784-94. DOI: 10.1056/NEJMoa0907441. View

Massaro D, Massaro G . Lung development, lung function, and retinoids. N Engl J Med. 2010; 362(19):1829-31. DOI: 10.1056/NEJMe1002366. View

Ali H, Hamadani J, Mehra S, Tofail F, Hasan M, Shaikh S . Effect of maternal antenatal and newborn supplementation with vitamin A on cognitive development of school-aged children in rural Bangladesh: a follow-up of a placebo-controlled, randomized trial. Am J Clin Nutr. 2017; 106(1):77-87. DOI: 10.3945/ajcn.116.134478. View

Yang C, Chen J, Liu Z, Yun C, Piao J, Yang X . Prevalence and influence factors of vitamin A deficiency of Chinese pregnant women. Nutr J. 2016; 15:12. PMC: 4729160. DOI: 10.1186/s12937-016-0131-7. View

Bates C . Vitamin A. Lancet. 1995; 345(8941):31-5. DOI: 10.1016/s0140-6736(95)91157-x. View

10.

Gal I, PARKINSON C . Effects of nutrition and other factors on pregnant women's serum vitamin A levels. Am J Clin Nutr. 1974; 27(7):688-95. DOI: 10.1093/ajcn/27.7.688. View

11.

Williams I, Essien E, Eka O . Socioeconomic factors and vitamin a status of pregnant women in Calabar urban, southeastern Nigeria. Matern Child Health J. 2009; 15(7):943-8. DOI: 10.1007/s10995-009-0541-7. View

12.

Neves P, Campos C, Malta M, Lourenco B, Castro M, Cardoso M . Predictors of vitamin A status among pregnant women in Western Brazilian Amazon. Br J Nutr. 2018; 121(2):202-211. DOI: 10.1017/S0007114518003112. View

13.

de Pee S, Dary O . Biochemical indicators of vitamin A deficiency: serum retinol and serum retinol binding protein. J Nutr. 2002; 132(9 Suppl):2895S-2901S. DOI: 10.1093/jn/132.9.2895S. View

14.

Li Y, Li H, Trasande L, Ge H, Yu L, Xu G . DHA in Pregnant and Lactating Women from Coastland, Lakeland, and Inland Areas of China: Results of a DHA Evaluation in Women (DEW) Study. Nutrients. 2015; 7(10):8723-32. PMC: 4632448. DOI: 10.3390/nu7105428. View

15.

Chen H, Qian N, Yan L, Jiang H . Role of serum vitamin A and E in pregnancy. Exp Ther Med. 2018; 16(6):5185-5189. PMC: 6257734. DOI: 10.3892/etm.2018.6830. View

16.

Handel M, Moon R, Titcombe P, Abrahamsen B, Heitmann B, Calder P . Maternal serum retinol and β-carotene concentrations and neonatal bone mineralization: results from the Southampton Women's Survey cohort. Am J Clin Nutr. 2016; 104(4):1183-1188. PMC: 5039809. DOI: 10.3945/ajcn.116.130146. View

17.

Abebe Z, Haki G, Schweigert F, Henkel I, Baye K . Low breastmilk vitamin A concentration is prevalent in rural Ethiopia. Eur J Clin Nutr. 2018; 73(8):1110-1116. DOI: 10.1038/s41430-018-0334-4. View

18.

da Silva A, Reboucas A, Mendonca B, Silva D, Dimenstein R, Ribeiro K . Relationship between the dietary intake, serum, and breast milk concentrations of vitamin A and vitamin E in a cohort of women over the course of lactation. Matern Child Nutr. 2018; 15(3):e12772. PMC: 7198973. DOI: 10.1111/mcn.12772. View

19.

de Lira L, Lima M, de Medeiros J, da Silva I, Dimenstein R . Correlation of vitamin A nutritional status on alpha-tocopherol in the colostrum of lactating women. Matern Child Nutr. 2011; 9(1):31-40. PMC: 6860850. DOI: 10.1111/j.1740-8709.2011.00376.x. View

20.

Saunders C, Ramalho R, De Lima A, Gomes M, Campos L, dos Santos Silva B . Association between gestational night blindness and serum retinol in mother/newborn pairs in the city of Rio de Janeiro, Brazil. Nutrition. 2005; 21(4):456-61. DOI: 10.1016/j.nut.2004.07.015. View